| CASE NUMBER | I-200-23268-378974 |
| CASE STATUS | Certified |
| RECEIVED DATE | 9/25/2023 |
| DECISION DATE | 10/2/2023 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Chief Resident |
| SOC CODE | 29-1229.00 |
| SOC TITLE | Physicians, All Other |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/1/2024 |
| END DATE | 6/30/2024 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 1 |
| EMPLOYER NAME | Bridgeport Hospital |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 267 Grant Street |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Bridgeport |
| EMPLOYER STATE | CT |
| EMPLOYER POSTAL CODE | 6610 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 12037843000 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 62211 |
| EMPLOYER POC LAST NAME | Hutchinson, M.D. |
| EMPLOYER POC FIRST NAME | Karen |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Chairman, Department of Medical Education |
| EMPLOYER POC ADDRESS1 | 267 Grant Street |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Bridgeport |
| EMPLOYER POC STATE | CT |
| EMPLOYER POC POSTAL CODE | 6610 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 12033843446 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | karen.hutchinson@bpthosp.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Hopwood |
| AGENT ATTORNEY FIRST NAME | Lauren |
| AGENT ATTORNEY MIDDLE NAME | Meris |
| AGENT ATTORNEY ADDRESS1 | 195 Church Street |
| AGENT ATTORNEY ADDRESS2 | 18th Floor |
| AGENT ATTORNEY CITY | New Haven |
| AGENT ATTORNEY STATE | CT |
| AGENT ATTORNEY POSTAL CODE | 6510 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12037843104 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | LHopwood@carmodylaw.com |
| LAWFIRM NAME BUSINESS NAME | Carmody Torrance Sandak and Hennessey LLP |
| STATE OF HIGHEST COURT | CT |
| NAME OF HIGHEST STATE COURT | Connecticut Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 267 Grant Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Bridgeport |
| WORKSITE COUNTY | FAIRFIELD |
| WORKSITE STATE | CT |
| WORKSITE POSTAL CODE | 6610 |
| WAGE RATE OF PAY FROM | 92082.5 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $74,417.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | |
| PW OES YEAR | |
| PW OTHER SOURCE | Survey |
| PW OTHER YEAR | 2022 |
| PW SURVEY PUBLISHER | AAMC |
| PW SURVEY NAME | Survey of Resident/Fellow Stipends and Benefits Report 2022 |
| 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 | Saravia |
| PREPARER FIRST NAME | Maria |
| PREPARER MIDDLE INITIAL | I. |
| PREPARER BUSINESS NAME | Carmody Torrance Sandak and Hennessey LLP |
| PREPARER EMAIL | msaravia@carmodylaw.com |
| BEGIN DATE CONVERTED | 2024-01-01 |
