| CASE NUMBER | I-200-24130-974497 |
| CASE STATUS | Certified |
| RECEIVED DATE | 5/8/2024 |
| DECISION DATE | 5/15/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Psychiatrist |
| SOC CODE | 29-1223.00 |
| SOC TITLE | Psychiatrists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/1/2024 |
| END DATE | 6/20/2027 |
| 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 | Northwest Community Health Care Center |
| TRADE NAME DBA | NEIGHBORHOOD HEALTH CENTER |
| EMPLOYER ADDRESS1 | 155 LAWN AVENUE |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | BUFFALO |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 14207 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 17168752904 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621999 |
| EMPLOYER POC LAST NAME | HAEFNER |
| EMPLOYER POC FIRST NAME | JOANNE |
| EMPLOYER POC MIDDLE NAME | E |
| EMPLOYER POC JOB TITLE | CHIEF EXECUTIVE OFFICER |
| EMPLOYER POC ADDRESS1 | 155 LAWN AVENUE |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | BUFFALO |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 14207 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 17168752904 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | J.HAEFNER@NWBCHCC.ORG |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Juncewicz |
| AGENT ATTORNEY FIRST NAME | Nina |
| AGENT ATTORNEY MIDDLE NAME | FRANCES |
| AGENT ATTORNEY ADDRESS1 | 50 Fountain Plaza |
| AGENT ATTORNEY ADDRESS2 | Suite 1400 |
| AGENT ATTORNEY CITY | Buffalo |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 14202 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 17168756500 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | njuncewicz@nfjlawoffice.com |
| LAWFIRM NAME BUSINESS NAME | The Law Office of Nina F. Juncewicz, P.C. |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | NEW YORK STATE COURT OF APPEALS |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 155 Lawn Avenue |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Buffalo |
| WORKSITE COUNTY | ERIE |
| WORKSITE STATE | NY |
| WORKSITE POSTAL CODE | 14207 |
| WAGE RATE OF PAY FROM | 305000 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $100,506.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 4 |
| 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 Employment |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-07 |
