| LCA CASE NUMBER | I-200-21167-404466 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-06-16 |
| DECISION DATE | 2021-06-24 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician (Hospitalist) |
| SOC CODE | 29-1069.03 |
| SOC TITLE | Hospitalists |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-01 |
| END DATE | 2024-06-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 1 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Hartford Healthcare Medical Group, Inc. |
| EMPLOYER ADDRESS1 | 1290 Silas Deane Highway |
| EMPLOYER ADDRESS2 | Floor 2 |
| EMPLOYER CITY | Wethersfield |
| EMPLOYER STATE | CT |
| EMPLOYER POSTAL CODE | 6109 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18606966180 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Czajkowski |
| EMPLOYER POC FIRST NAME | Marcie |
| EMPLOYER POC JOB TITLE | Coordinator, Physician & Advanced Practioner Recruitment |
| EMPLOYER POC ADDRESS 1 | 389 JOHN DOWNEY DRIVE |
| EMPLOYER POC CITY | NEW BRITAIN |
| EMPLOYER POC STATE | CT |
| EMPLOYER POC POSTAL CODE | 06051 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18606966180 |
| EMPLOYER POC EMAIL | marcie.czajkowski@hhchealth.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Fillenwarth |
| AGENT ATTORNEY FIRST NAME | Charlotte |
| AGENT ATTORNEY MIDDLE NAME | Marie |
| AGENT ATTORNEY ADDRESS1 | 500 North Meridian Street |
| AGENT ATTORNEY ADDRESS2 | Suite 400 |
| AGENT ATTORNEY CITY | Indianapolis |
| AGENT ATTORNEY STATE | IN |
| AGENT ATTORNEY POSTAL CODE | 46204 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 13179771476 |
| AGENT ATTORNEY EMAIL ADDRESS | cfillenwarth@hallrender.com |
| LAWFIRM NAME BUSINESS NAME | Hall, Render, Killian, Heath & Lyman, P.C. |
| STATE OF HIGHEST COURT | IN |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | True |
| SECONDARY ENTITY BUSINESS NAME | St. Vincent's Medical Center |
| WORKSITE ADDRESS1 | 2800 Main Street |
| LCA CASE WORKLOC1 CITY | Bridgeport |
| WORKSITE COUNTY | BRIDGEPORT CITY |
| LCA CASE WORKLOC1 STATE | CT |
| WORKSITE POSTAL CODE | 6606 |
| LCA CASE WAGE RATE FROM | 208000 |
| LCA CASE WAGE RATE TO | 280000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 208000 |
| PW UNIT OF PAY | Year |
| 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 |
