| CASE NUMBER | I-200-24124-955208 |
| CASE STATUS | Certified |
| RECEIVED DATE | 5/3/2024 |
| DECISION DATE | 5/10/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Resident/Fellow |
| SOC CODE | 29-1229.00 |
| SOC TITLE | Physicians, All Other |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/1/2024 |
| END DATE | 6/30/2025 |
| 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 | Northwell Health |
| TRADE NAME DBA | Northwell Health |
| EMPLOYER ADDRESS1 | 1111 Marcus Avenue |
| EMPLOYER ADDRESS2 | Office of Academic Affairs |
| EMPLOYER CITY | New Hyde Park |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 11042 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15162665050 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 6221 |
| EMPLOYER POC LAST NAME | VanHuse |
| EMPLOYER POC FIRST NAME | Venice |
| EMPLOYER POC MIDDLE NAME | Marie |
| EMPLOYER POC JOB TITLE | Vice President, Academic Affairs |
| EMPLOYER POC ADDRESS1 | 1111 Marcus Avenue |
| EMPLOYER POC ADDRESS2 | Office of Academic Affairs |
| EMPLOYER POC CITY | New Hyde Park |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 11042 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 15162665050 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | vvanhuse@northwell.edu |
| AGENT REPRESENTING EMPLOYER | No |
| AGENT ATTORNEY LAST NAME | |
| AGENT ATTORNEY FIRST NAME | |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | |
| AGENT ATTORNEY STATE | |
| AGENT ATTORNEY POSTAL CODE | |
| AGENT ATTORNEY COUNTRY | |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | |
| LAWFIRM NAME BUSINESS NAME | |
| STATE OF HIGHEST COURT | |
| NAME OF HIGHEST STATE COURT | |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 270-05 76th Avenue |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Queens |
| WORKSITE COUNTY | QUEENS |
| WORKSITE STATE | NY |
| WORKSITE POSTAL CODE | 11040 |
| WAGE RATE OF PAY FROM | 89775 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $78,665.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | |
| PW OES YEAR | |
| PW OTHER SOURCE | Survey |
| PW OTHER YEAR | 2023 |
| PW SURVEY PUBLISHER | AAMC |
| PW SURVEY NAME | Survey of Resident/Fellow Stipends and Benefits Report |
| TOTAL WORKSITE LOCATIONS | 5 |
| 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 |
