| CASE NUMBER | I-200-24176-143377 |
| CASE STATUS | Certified |
| RECEIVED DATE | 6/24/2024 |
| DECISION DATE | 7/1/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Inpatient Hospitalist |
| SOC CODE | 29-1216.00 |
| SOC TITLE | General Internal Medicine Physicians |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/1/2024 |
| END DATE | 6/30/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Maimonides Medical Center |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 4802 Tenth Avenue |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Brooklyn |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 11219 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +17182836000 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Wright |
| EMPLOYER POC FIRST NAME | Alicia |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | HR Business Partner |
| EMPLOYER POC ADDRESS1 | 4802 10th Avenue |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Brooklyn |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 11219 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +17182836000 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | AWright@maimonidesmed.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Lang |
| AGENT ATTORNEY FIRST NAME | Jessica |
| AGENT ATTORNEY MIDDLE NAME | K |
| AGENT ATTORNEY ADDRESS1 | 75 Park Plaza |
| AGENT ATTORNEY ADDRESS2 | 4th Floor |
| AGENT ATTORNEY CITY | Boston |
| AGENT ATTORNEY STATE | MA |
| AGENT ATTORNEY POSTAL CODE | 02116 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +16173670025 |
| AGENT ATTORNEY PHONE EXT | 1228 |
| AGENT ATTORNEY EMAIL ADDRESS | Jessica.Lang@jacksonlewis.com |
| LAWFIRM NAME BUSINESS NAME | Jackson Lewis P.C. |
| STATE OF HIGHEST COURT | MA |
| NAME OF HIGHEST STATE COURT | Supreme Judicial Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 4802, 10th Avenue |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Brooklyn |
| WORKSITE COUNTY | KINGS |
| WORKSITE STATE | NY |
| WORKSITE POSTAL CODE | 11219 |
| WAGE RATE OF PAY FROM | 217,691.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $160,326.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| 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 | Spisso |
| PREPARER FIRST NAME | Alessandra |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | Jackson Lewis P.C. |
| PREPARER EMAIL | Alessandra.spisso@jacksonlewis.com |
| BEGIN DATE CONVERTED | 2024-01-07 |
