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Phoebus Widjaja, LMSW

NPI 1366377996 · on the registry since 2026 · sole proprietor

Practice

Address
4021 60th St Apt 2
Woodside, NY 11377
Phone
(917) 595-8969

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Licence states on file
NY
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-06-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York