| CASE NUMBER | I-200-24180-159054 |
| CASE STATUS | Certified |
| RECEIVED DATE | 6/28/2024 |
| DECISION DATE | 7/8/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Attending Physician |
| SOC CODE | 29-1218.00 |
| SOC TITLE | Obstetricians and Gynecologists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 10/7/2024 |
| END DATE | 10/6/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | PHYSICIAN AFFILIATE GROUP OF NY, PC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 420 Lexington Avenue |
| EMPLOYER ADDRESS2 | SUITE 1750 |
| EMPLOYER CITY | NEW YORK |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 10170 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +16466723650 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Ingram-Lewis |
| EMPLOYER POC FIRST NAME | Latoya |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | HR, Immigration Specialist |
| EMPLOYER POC ADDRESS1 | 420 Lexington Avenue |
| EMPLOYER POC ADDRESS2 | SUITE 1750 |
| EMPLOYER POC CITY | NEW YORK |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 10170 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +16467142109 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | ingraml@pagny.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | PERLITSH |
| AGENT ATTORNEY FIRST NAME | STEPHEN |
| AGENT ATTORNEY MIDDLE NAME | MURRAY |
| AGENT ATTORNEY ADDRESS1 | 110 WEST 34TH STREET |
| AGENT ATTORNEY ADDRESS2 | SUITE 300 |
| AGENT ATTORNEY CITY | NEW YORK |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 10001 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +12128403878 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | JUSTINE@PERLITSH.COM |
| LAWFIRM NAME BUSINESS NAME | LAW OFFICE OF STEPHEN M. PERLITSH |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | NYC H+H/Lincoln |
| WORKSITE ADDRESS1 | 234 East 149th Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Bronx |
| WORKSITE COUNTY | BRONX |
| WORKSITE STATE | NY |
| WORKSITE POSTAL CODE | 10451 |
| WAGE RATE OF PAY FROM | 260,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $260,000.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | |
| PW OES YEAR | |
| PW OTHER SOURCE | CBA |
| PW OTHER YEAR | 2024 |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Han |
| PREPARER FIRST NAME | Hea |
| PREPARER MIDDLE INITIAL | W |
| PREPARER BUSINESS NAME | Law Office of Stephen M. Perlitsh |
| PREPARER EMAIL | justine@perlitsh.com |
| BEGIN DATE CONVERTED | 2024-07-10 |
