| CASE NUMBER | I-200-25001-584283 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/1/2025 |
| DECISION DATE | 1/8/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Nephrologist |
| SOC CODE | 29-1216.00 |
| SOC TITLE | General Internal Medicine Physicians |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/1/2025 |
| END DATE | 6/30/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Connecticut Kidney & Hypertension Specialists, LLC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 140 Grandview Avenue |
| EMPLOYER ADDRESS2 | Suite 101 |
| EMPLOYER CITY | Waterbury |
| EMPLOYER STATE | CT |
| EMPLOYER POSTAL CODE | 6708 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 12035979733 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Butkevicius |
| EMPLOYER POC FIRST NAME | Grace |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Office Manager |
| EMPLOYER POC ADDRESS1 | 140 Grandview Avenue |
| EMPLOYER POC ADDRESS2 | Suite 101 |
| EMPLOYER POC CITY | Waterbury |
| EMPLOYER POC STATE | CT |
| EMPLOYER POC POSTAL CODE | 6708 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 12035979733 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | mgmbutkevicius@gmail.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Pelc-Faszcza |
| AGENT ATTORNEY FIRST NAME | Nina |
| AGENT ATTORNEY MIDDLE NAME | Bethany |
| AGENT ATTORNEY ADDRESS1 | One Constitution Plaza |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | Hartford |
| AGENT ATTORNEY STATE | CT |
| AGENT ATTORNEY POSTAL CODE | 6103 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 18602515024 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | npelcfaszcza@goodwin.com |
| LAWFIRM NAME BUSINESS NAME | Shipman & Goodwin LLP |
| STATE OF HIGHEST COURT | CT |
| NAME OF HIGHEST STATE COURT | Superior Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | Charlotte Hungerford Hospital |
| WORKSITE ADDRESS1 | 540 Litchfield Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Torrington |
| WORKSITE COUNTY | TORRINGTON |
| WORKSITE STATE | CT |
| WORKSITE POSTAL CODE | 6790 |
| WAGE RATE OF PAY FROM | $239,200.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $321,534.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $239,200.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | N/A |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 6 |
| 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 | Hancock |
| PREPARER FIRST NAME | Jennifer |
| PREPARER MIDDLE INITIAL | L |
| PREPARER BUSINESS NAME | Shipman & Goodwin LLP |
| PREPARER EMAIL | jhancock@goodwin.com |
| BEGIN DATE CONVERTED | 2025-07-01 |
