| CASE NUMBER | I-200-24306-448340 |
| CASE STATUS | Certified |
| RECEIVED DATE | 11/1/2024 |
| DECISION DATE | 11/8/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Psychiatrist |
| SOC CODE | 29-1223.00 |
| SOC TITLE | Psychiatrists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/6/2025 |
| END DATE | 1/5/2028 |
| 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 | The Mary Imogene Bassett Hospital |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 1 Atwell Road |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Cooperstown |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 13326 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 16075476982 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Coveny |
| EMPLOYER POC FIRST NAME | Stacy |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Senior Retention Specialist |
| EMPLOYER POC ADDRESS1 | 1 Atwell Road |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Cooperstown |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 13326 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 16075476982 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | stacy.coveny@bassett.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Bruno |
| AGENT ATTORNEY FIRST NAME | Sandra |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 1 Olympic Place |
| AGENT ATTORNEY ADDRESS2 | Suite 800 |
| AGENT ATTORNEY CITY | Towson |
| AGENT ATTORNEY STATE | MD |
| AGENT ATTORNEY POSTAL CODE | 21204 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 14106591397 |
| AGENT ATTORNEY PHONE EXT | 621 |
| AGENT ATTORNEY EMAIL ADDRESS | sbrunolaw@gmail.com |
| LAWFIRM NAME BUSINESS NAME | Wright, Constable & Skeen, LLP |
| STATE OF HIGHEST COURT | IL |
| NAME OF HIGHEST STATE COURT | The Supreme Court of Illinois |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1 Atwell Road |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Cooperstown |
| WORKSITE COUNTY | OTSEGO |
| WORKSITE STATE | NY |
| WORKSITE POSTAL CODE | 13326 |
| WAGE RATE OF PAY FROM | $320,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $147,347.00 |
| 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 | 3 |
| 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 | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-01-06 |
