| CASE NUMBER | I-200-24341-525196 |
| CASE STATUS | Certified |
| RECEIVED DATE | 12/6/2024 |
| DECISION DATE | 12/13/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Pediatrician |
| SOC CODE | 29-1221.00 |
| SOC TITLE | Pediatricians, General |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/13/2025 |
| END DATE | 1/12/2028 |
| 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 | Urban Health Plan, Inc. |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 1065 Southern Boulevard |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Bronx |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 10459 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 17185862440 |
| EMPLOYER PHONE EXT | 4726 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Martinez-Lewis |
| EMPLOYER POC FIRST NAME | Yamileth |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Chief of Experience |
| EMPLOYER POC ADDRESS1 | 960 Southern Boulevard |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Bronx |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 10459 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 17185892440 |
| EMPLOYER POC PHONE EXT | 4726 |
| EMPLOYER POC EMAIL | yamileth.martinez@urbanhealthplan.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Perlitsh |
| AGENT ATTORNEY FIRST NAME | Stephen |
| AGENT ATTORNEY MIDDLE NAME | Murray |
| AGENT ATTORNEY ADDRESS1 | 110 West 34th Street |
| AGENT ATTORNEY ADDRESS2 | Suite 300 |
| AGENT ATTORNEY CITY | New York |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 10001 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12128403878 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | justine@perlitsh.com |
| LAWFIRM NAME BUSINESS NAME | Law Office of Stephen M. Perlitsh |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 37-12 108th Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Corona |
| WORKSITE COUNTY | QUEENS |
| WORKSITE STATE | NY |
| WORKSITE POSTAL CODE | 11368 |
| WAGE RATE OF PAY FROM | $210,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $119,392.00 |
| PW UNIT OF PAY | Year |
| 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 | 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 | Han |
| PREPARER FIRST NAME | Hea |
| PREPARER MIDDLE INITIAL | W |
| PREPARER BUSINESS NAME | Law Office of Stephen M. Perlitsh |
| PREPARER EMAIL | justine@perlitsh.com |
| BEGIN DATE CONVERTED | 2025-01-13 |
