| CASE NUMBER | I-200-25034-662317 |
| CASE STATUS | Certified |
| RECEIVED DATE | 2/3/2025 |
| DECISION DATE | 2/10/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | 340B & Pharm Data Analyst |
| SOC CODE | 13-1111.00 |
| SOC TITLE | Management Analysts |
| FULL TIME POSITION | Y |
| BEGIN DATE | 2/17/2025 |
| END DATE | 2/16/2028 |
| 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 | The Stamford Hospital |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | One Hospital Plaza |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Stamford |
| EMPLOYER STATE | CT |
| EMPLOYER POSTAL CODE | 6902 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 12032765901 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Kozlow |
| EMPLOYER POC FIRST NAME | Erin |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Human Resource Business Partner |
| EMPLOYER POC ADDRESS1 | One Hospital Plaza |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Stamford |
| EMPLOYER POC STATE | CT |
| EMPLOYER POC POSTAL CODE | 6902 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 12032765901 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | ekozlow@stamhealth.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Manning |
| AGENT ATTORNEY FIRST NAME | William |
| AGENT ATTORNEY MIDDLE NAME | J |
| 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 | 19148726891 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | william.manning@jacksonlewis.com |
| LAWFIRM NAME BUSINESS NAME | Jackson Lewis PC |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | One Hospital Plaza |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Stamford |
| WORKSITE COUNTY | FAIRFIELD |
| WORKSITE STATE | CT |
| WORKSITE POSTAL CODE | 6902 |
| WAGE RATE OF PAY FROM | $81,120.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $76,086.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| 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 | Dave |
| PREPARER FIRST NAME | Bhagyashri |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | Jackson Lewis PC |
| PREPARER EMAIL | bhagyashri.dave@jacksonlewis.com |
| BEGIN DATE CONVERTED | 2025-02-17 |
