| CASE NUMBER | I-200-24079-812467 |
| CASE STATUS | Certified |
| RECEIVED DATE | 3/19/2024 |
| DECISION DATE | 3/26/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Hospitalist |
| SOC CODE | 29-1229.00 |
| SOC TITLE | Physicians, All Other |
| FULL TIME POSITION | N |
| BEGIN DATE | 7/1/2024 |
| END DATE | 10/31/2024 |
| 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 | Northeast Medical Group, Inc. |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 99 Hawley Lane |
| EMPLOYER ADDRESS2 | 1st Floor |
| EMPLOYER CITY | Stratford |
| EMPLOYER STATE | CT |
| EMPLOYER POSTAL CODE | 06614 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +18556364637 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Stewart |
| EMPLOYER POC FIRST NAME | Tyrita |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Associate Director, Clinician Recruitment & Onboarding |
| EMPLOYER POC ADDRESS1 | 99 Hawley Lane |
| EMPLOYER POC ADDRESS2 | 1st Floor |
| EMPLOYER POC CITY | Stratford |
| EMPLOYER POC STATE | CT |
| EMPLOYER POC POSTAL CODE | 06614 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +12035024921 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | Tyrita.Stewart@ynhh.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 | 06510 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +12037843112 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | lhopwood@carmodylaw.com |
| LAWFIRM NAME BUSINESS NAME | Carmody Torrance Sandak & Hennessey LLP |
| STATE OF HIGHEST COURT | CT |
| NAME OF HIGHEST STATE COURT | Connecticut Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | Bridgeport Hospital |
| WORKSITE ADDRESS1 | 267 Grant Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Bridgeport |
| WORKSITE COUNTY | BRIDGEPORT CITY |
| WORKSITE STATE | CT |
| WORKSITE POSTAL CODE | 06610 |
| WAGE RATE OF PAY FROM | 125.7 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $115.00 |
| PW UNIT OF PAY | Hour |
| 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 | Williams |
| PREPARER FIRST NAME | Brooke |
| PREPARER MIDDLE INITIAL | A |
| PREPARER BUSINESS NAME | Carmody Torrance Sandak & Hennessey LLP |
| PREPARER EMAIL | bwilliams@carmodylaw.com |
| BEGIN DATE CONVERTED | 2024-01-07 |
