| CASE NUMBER | I-200-25017-626606 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/17/2025 |
| DECISION DATE | 1/27/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Medical Doctor |
| SOC CODE | 29-1215.00 |
| SOC TITLE | Family Medicine Physicians |
| FULL TIME POSITION | N |
| BEGIN DATE | 1/24/2025 |
| END DATE | 1/23/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 1 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | 1211 WPR Medical Services PC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 1211 White Plains Road |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Bronx |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 10472 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 17188286610 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 6211 |
| EMPLOYER POC LAST NAME | Diaz |
| EMPLOYER POC FIRST NAME | Linda |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Supervisor Finance |
| EMPLOYER POC ADDRESS1 | 660 White Plains Road |
| EMPLOYER POC ADDRESS2 | STE 525 |
| EMPLOYER POC CITY | Tarrytown |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 10591 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 19145240500 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | ldiaz@insightmanagement.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Corigliano |
| AGENT ATTORNEY FIRST NAME | Dina |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 20E Vanderventer Ave |
| AGENT ATTORNEY ADDRESS2 | Suite 105 |
| AGENT ATTORNEY CITY | Port Washington |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 11050 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12127644222 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | DCORIGLIANO@jeffries-law.com |
| LAWFIRM NAME BUSINESS NAME | Jeffries and Corigliano LLP |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1211 White Plains Road |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Bronx |
| WORKSITE COUNTY | BRONX |
| WORKSITE STATE | NY |
| WORKSITE POSTAL CODE | 10472 |
| WAGE RATE OF PAY FROM | $80.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $76.15 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| 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 | Corigliano |
| PREPARER FIRST NAME | Dina |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | Jeffries & Corigliano LLP |
| PREPARER EMAIL | DCORIGLIANO@jeffries-law.com |
| BEGIN DATE CONVERTED | 2025-01-24 |
