| LCA CASE NUMBER | I-200-21165-394667 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-06-14 |
| DECISION DATE | 2021-06-22 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Family Medicine Physician |
| SOC CODE | 29-1062.00 |
| SOC TITLE | Family and General Practitioners |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-08-02 |
| END DATE | 2024-08-01 |
| 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 | Hudson Headwaters Health Network |
| EMPLOYER ADDRESS1 | 9 Carey Road |
| EMPLOYER CITY | Queensbury |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 12804 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15157610300 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Slingerland, MD |
| EMPLOYER POC FIRST NAME | D. Tucker |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS 1 | 9 Carey Road |
| EMPLOYER POC CITY | Queensbury |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 12804 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15157610300 |
| EMPLOYER POC EMAIL | howdychris@yahoo.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Piasecki |
| AGENT ATTORNEY FIRST NAME | Kolette |
| AGENT ATTORNEY MIDDLE NAME | C. |
| AGENT ATTORNEY ADDRESS1 | 908 Niagara Falls Blvd. |
| AGENT ATTORNEY ADDRESS2 | Ste 252 |
| AGENT ATTORNEY CITY | North Tonawanda |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 14120 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | NY |
| AGENT ATTORNEY PHONE | 17164803936 |
| AGENT ATTORNEY PHONE EXT | 101 |
| AGENT ATTORNEY EMAIL ADDRESS | kolette@knpvisa.com |
| LAWFIRM NAME BUSINESS NAME | Kresses & Piasecki Legal PC |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | U.S. District Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 102 Race Track Road |
| LCA CASE WORKLOC1 CITY | Ticonderoga |
| WORKSITE COUNTY | ESSEX |
| LCA CASE WORKLOC1 STATE | NY |
| WORKSITE POSTAL CODE | 12883 |
| LCA CASE WAGE RATE FROM | 210000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 137904 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 3 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Piasecki |
| PREPARER FIRST NAME | Kolette |
| PREPARER MIDDLE INITIAL | C. |
| PREPARER BUSINESS NAME | Kresses & Piasecki Legal PC |
| PREPARER EMAIL | Kolette@knpvisa.com |
