vanity is now https://vanitymedicalspa.com/coolsculpting-teaneck/
also I'm seeing grace come up-
please advice 

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Whitney,
Good morning.
That would be something for Shane to answer as he is the one who handles the location settings.

I tried CS NJ and got this -

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whitney.zelig@gmail.com I got you. 
Went ahead and replaced the wrong URL on all ads with this one = https://vanitymedicalspa.com/coolsculpting-teaneck/

Hey Hector, better to let me handle this kind of thing.  All of the ads got disapproved. Appreciate the help, but ping me first.

I'm not sure when the LP changed, but I have it updated now.

whitney.zelig@gmail.com  Where were you geographically when the Grace Medical ad appeared? 

Shane, all I did was update the URL. I am not seeing any of the ads disapproved.

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Shane  I was in Manhattan I googled "coolsculpting los angeles"

Could it be a "retargeting ad" 

Ive never seen our other client's ads before- just skinneys

So my guess is that Google thinks you've been in New Jersey "a lot" by whatever number of times they deem as "a lot."  I can exclude NY entirely. 

Google; the proverbial snooper who like Facebook, Apple & Amazon want to know your every move. 
I would suggest trying it in Incognito mode. 
Also, download the program I mentioned Whitney. Google & other tracking mining companies hate it.