| LCA CASE NUMBER | I-200-21056-101879 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-02-25 |
| DECISION DATE | 2021-03-04 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician in a Post Graduate Training Program |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| 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 | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Maimonides Medical Center |
| EMPLOYER ADDRESS1 | 4802 Tenth Avenue |
| EMPLOYER CITY | Brooklyn |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 11219 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17182836000 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Hughes-Koncz |
| EMPLOYER POC FIRST NAME | Jennifer |
| EMPLOYER POC JOB TITLE | Administrative Manager of Graduate Medical Education |
| EMPLOYER POC ADDRESS 1 | 4802 Tenth Avenue |
| EMPLOYER POC CITY | Brooklyn |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 11219 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17182836879 |
| EMPLOYER POC EMAIL | jhughes@maimonidesmed.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Eliot |
| AGENT ATTORNEY FIRST NAME | Anita |
| AGENT ATTORNEY ADDRESS1 | 10-27 46th Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 300-2 |
| AGENT ATTORNEY CITY | Long Island City |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 11101 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12123568195 |
| AGENT ATTORNEY EMAIL ADDRESS | aeliot@cirseiu.org |
| LAWFIRM NAME BUSINESS NAME | Voluntary Hospitals House Staff Benefits Plan |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Appellate Division, Second Department |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 4802 Tenth Avenue |
| LCA CASE WORKLOC1 CITY | Brooklyn |
| WORKSITE COUNTY | KINGS |
| LCA CASE WORKLOC1 STATE | NY |
| WORKSITE POSTAL CODE | 11219 |
| LCA CASE WAGE RATE FROM | 77624 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 77624 |
| PW UNIT OF PAY | Year |
| PW OTHER SOURCE | CBA |
| PW OTHER YEAR | 2019 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Ramirez |
| PREPARER FIRST NAME | Sarah |
| PREPARER MIDDLE INITIAL | M |
| PREPARER BUSINESS NAME | Voluntary Hospitals House Staff Benefits Plan |
| PREPARER EMAIL | sramirez@cirseiu.org |
