| LCA CASE NUMBER | I-200-21224-518204 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-08-12 |
| DECISION DATE | 2021-08-19 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Urologist |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-09-01 |
| END DATE | 2024-07-04 |
| 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 | Penn State Health Community Medical Group, LLC |
| EMPLOYER ADDRESS1 | 100 Crystal A Drive, P.O. Box 804 |
| EMPLOYER ADDRESS2 | MC CA230 |
| EMPLOYER CITY | Hershey |
| EMPLOYER STATE | PA |
| EMPLOYER POSTAL CODE | 17033 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17175310003 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | HA |
| EMPLOYER POC FIRST NAME | Nhung |
| EMPLOYER POC JOB TITLE | Specialist, Visa Services |
| EMPLOYER POC ADDRESS1 | 100 Crystal A Drive, P.O. Box 804 |
| EMPLOYER POC ADDRESS2 | MC CA230 |
| EMPLOYER POC CITY | Hershey |
| EMPLOYER POC STATE | PA |
| EMPLOYER POC POSTAL CODE | 17033 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17175310003 |
| EMPLOYER POC EMAIL | nhungha@pennstatehealth.psu.edu |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | POLLINS |
| AGENT ATTORNEY FIRST NAME | Karen |
| AGENT ATTORNEY MIDDLE NAME | M. |
| AGENT ATTORNEY ADDRESS1 | 101 Greenwood Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 380 |
| AGENT ATTORNEY CITY | Jenkintown |
| AGENT ATTORNEY STATE | PA |
| AGENT ATTORNEY POSTAL CODE | 19046 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12158853600 |
| AGENT ATTORNEY EMAIL ADDRESS | karen@goldblumfirm.com |
|
| LAWFIRM NAME BUSINESS NAME | Goldblum & Pollins, P.C. |
| STATE OF HIGHEST COURT | PA |
| NAME OF HIGHEST STATE COURT | Pennsylvania Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 503 N. 21st, St. |
| LCA CASE WORKLOC1 CITY | Camp Hill |
| WORKSITE COUNTY | CUMBERLAND |
| LCA CASE WORKLOC1 STATE | PA |
| WORKSITE POSTAL CODE | 17011 |
| LCA CASE WAGE RATE FROM | 451849 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 56742 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 4 |
| AGREE TO LC STATEMENT | True |
| H-1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | POLLINS |
| PREPARER FIRST NAME | Karen |
| PREPARER MIDDLE INITIAL | M |
| PREPARER BUSINESS NAME | Goldblum & Pollins, P.C. |
| PREPARER EMAIL | karen@goldblumfirm.com |
