Five Journeys Referrals

Referrals from
Five Journeys

Please fill out the form completely and plan accordingly as it may take up to two weeks to obtain a referral. 
Thank you.

 

Referrals to Five Journeys

To request a referral from your PCP to see our medical providers, please provide them with the following information.  

Please fax the information to 617-934-6401.

If we do not receive this information before your first appointment, you will be charged for the visit and then reimbursed when the referral arrives. Thank you. 

Please include:
  • The date of your first appointment
  • Number of visits – 12
  • The reason for your visit
  • Our Fax # 617-934-6401

    The name and NPI# of your provider:

  • Edward Levitan, MD
    NPI# 1740393222

  • Wendie Trubow, MD
    NPI# 1730258237

  • Marinela Lavena, MD
    NPI# 1760647770