| LCA CASE NUMBER | I-200-20064-375298 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-03-04 |
| DECISION DATE | 2020-03-11 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Pediatric Physician |
| SOC CODE | 29-1065.00 |
| SOC TITLE | Pediatricians, General |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-07-01 |
| END DATE | 2023-06-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | StayWell Health Care, Inc. |
| EMPLOYER ADDRESS1 | 80 Phoenix Avenue |
| EMPLOYER ADDRESS2 | Suite 201 |
| EMPLOYER CITY | Waterbury |
| EMPLOYER STATE | CT |
| EMPLOYER POSTAL CODE | 6702 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 12037568021 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Tripp |
| EMPLOYER POC FIRST NAME | Lynn |
| EMPLOYER POC JOB TITLE | Human Resource Director |
| EMPLOYER POC ADDRESS1 | 80 Phoenix Avenue |
| EMPLOYER POC ADDRESS2 | Suite 201 |
| EMPLOYER POC CITY | Waterbury |
| EMPLOYER POC STATE | CT |
| EMPLOYER POC POSTAL CODE | 6702 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 12037568021 |
| EMPLOYER POC PHONE EXT | 3017.0 |
| EMPLOYER POC EMAIL | ltripp@staywellhealth.org |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Hopwood |
| AGENT ATTORNEY FIRST NAME | Lauren |
| AGENT ATTORNEY MIDDLE NAME | Meris |
| AGENT ATTORNEY ADDRESS1 | 195 Church Street |
| AGENT ATTORNEY ADDRESS2 | 18th Floor |
| AGENT ATTORNEY CITY | New Haven |
| AGENT ATTORNEY STATE | CT |
| AGENT ATTORNEY POSTAL CODE | 06510 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12037843104.0 |
| AGENT ATTORNEY EMAIL ADDRESS | jbuydos@carmodylaw.com |
| LAWFIRM NAME BUSINESS NAME | Carmody Torrance Sandak & Hennessey |
| STATE OF HIGHEST COURT | CT |
| NAME OF HIGHEST STATE COURT | Connecticut Supreme Court |
| WORKSITE WORKERS | 1.0 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 80 Phoenix Avenue |
| LCA CASE WORKLOC1 CITY | Waterbury |
| WORKSITE COUNTY | WATERBURY CITY |
| LCA CASE WORKLOC1 STATE | CT |
| WORKSITE POSTAL CODE | 6702 |
| LCA CASE WAGE RATE FROM | 174512.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 159661.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 1.0 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Buydos |
| PREPARER FIRST NAME | Jill |
| PREPARER MIDDLE INITIAL | G. |
| PREPARER BUSINESS NAME | Carmody Torrance Sandak & Hennessey LLP |
| PREPARER EMAIL | jbuydos@carmodylaw.com |
