Provider Demographics
NPI:1982456109
Name:URBAN FACIAL PLASTICS LLC
Entity Type:Organization
Organization Name:URBAN FACIAL PLASTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:URBAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-879-2222
Mailing Address - Street 1:385 STATE ROUTE 24
Mailing Address - Street 2:STE 3K
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930-2910
Mailing Address - Country:US
Mailing Address - Phone:908-879-2222
Mailing Address - Fax:283-205-2239
Practice Address - Street 1:385 STATE ROUTE 24
Practice Address - Street 2:STE 3K
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2910
Practice Address - Country:US
Practice Address - Phone:908-879-2222
Practice Address - Fax:283-205-2239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery