| LCA CASE NUMBER | I-200-21111-247287 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-21 |
| DECISION DATE | 2021-04-28 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Family Nurse Practitioner |
| SOC CODE | 29-1171.00 |
| SOC TITLE | Nurse Practitioners |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-10-01 |
| END DATE | 2024-09-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | EVERGREEN MEDICAL CLINIC PC |
| EMPLOYER ADDRESS1 | 77 BOWERY 3F |
| EMPLOYER CITY | NEW YORK |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 10002 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17186808881 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | He |
| EMPLOYER POC FIRST NAME | Yong Kang |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS 1 | 77 BOWERY 3F |
| EMPLOYER POC CITY | NEW YORK |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 10002 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17186808881 |
| EMPLOYER POC EMAIL | YKMEDICAL755@GMAIL.COM |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Su |
| AGENT ATTORNEY FIRST NAME | Chenping |
| AGENT ATTORNEY ADDRESS1 | 1065 6th Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 1025 |
| AGENT ATTORNEY CITY | New York |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 10018 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12129206947 |
| AGENT ATTORNEY EMAIL ADDRESS | INFO@NYISLAWFIRM.COM |
| LAWFIRM NAME BUSINESS NAME | NYIS Law Firm |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | New York State Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 77 BOWERY 3F |
| LCA CASE WORKLOC1 CITY | New York |
| WORKSITE COUNTY | NEW YORK |
| LCA CASE WORKLOC1 STATE | NY |
| WORKSITE POSTAL CODE | 10002 |
| LCA CASE WAGE RATE FROM | 140000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 128731 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business and Employment |
