| CASE NUMBER | I-200-23312-486194 |
| CASE STATUS | Certified |
| RECEIVED DATE | 11/8/2023 |
| DECISION DATE | 11/16/2023 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Certified Registered Nurse Anesthetist |
| SOC CODE | 29-1151.00 |
| SOC TITLE | Nurse Anesthetists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 2/1/2024 |
| END DATE | 1/31/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 1 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | North America Partners in Anesthesia of New Jersey, L.L.C |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 1305 Walt Whitman Road |
| EMPLOYER ADDRESS2 | Suite 300 |
| EMPLOYER CITY | Melville |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 11747 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15169453348 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Boateng |
| EMPLOYER POC FIRST NAME | Christine |
| EMPLOYER POC MIDDLE NAME | E |
| EMPLOYER POC JOB TITLE | Director, Human Resources |
| EMPLOYER POC ADDRESS1 | 1300 Concord Terrace |
| EMPLOYER POC ADDRESS2 | Suite 420 |
| EMPLOYER POC CITY | Sunrise |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 33323 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 17542474087 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | cboateng@napaanesthesia.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Ombok |
| AGENT ATTORNEY FIRST NAME | Otieno |
| AGENT ATTORNEY MIDDLE NAME | B |
| AGENT ATTORNEY ADDRESS1 | 44 South Broadway |
| AGENT ATTORNEY ADDRESS2 | 14th Floor |
| AGENT ATTORNEY CITY | White Plains |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 10601 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 19148726895 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | Otieno.Ombok@jacksonlewis.com |
| LAWFIRM NAME BUSINESS NAME | Jackson Lewis P.C. |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | Overlook Medical Center |
| WORKSITE ADDRESS1 | 99 Beauvoir Avenue |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Summit |
| WORKSITE COUNTY | UNION |
| WORKSITE STATE | NJ |
| WORKSITE POSTAL CODE | 7901 |
| WAGE RATE OF PAY FROM | 254987.2 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $239,200.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | N/A |
| 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 | N/A |
| PREPARER FIRST NAME | N/A |
| PREPARER MIDDLE INITIAL | N/A |
| PREPARER BUSINESS NAME | Jackson Lewis P.C. |
| PREPARER EMAIL | Otieno.Ombok@jacksonlewis.com |
| BEGIN DATE CONVERTED | 2024-01-02 |
