| LCA CASE NUMBER | I-200-21281-633842 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-10-08 |
| DECISION DATE | 2021-10-18 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | HOSPITALIST PHYSICIAN |
| SOC CODE | 29-1069.03 |
| SOC TITLE | Hospitalists |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-11-01 |
| END DATE | 2024-10-30 |
| TOTAL WORKER POSITIONS | 2 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 2 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | HOSPITALIST SERVICES OF OLEAN, P.C. |
| EMPLOYER ADDRESS1 | 1201 W SWANN AVE |
| EMPLOYER CITY | TAMPA |
| EMPLOYER STATE | FL |
| EMPLOYER POSTAL CODE | 33606 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18102535400 |
| EMPLOYER PHONE EXT | 216 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | ERVAST |
| EMPLOYER POC FIRST NAME | Donna |
| EMPLOYER POC JOB TITLE | PRESIDENT |
| EMPLOYER POC ADDRESS1 | 1201 W SWANN AVE |
| EMPLOYER POC CITY | TAMPA |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 33606 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18132535400 |
| EMPLOYER POC PHONE EXT | 202 |
| EMPLOYER POC EMAIL | HR@KEYSTONEHEALTHCARE.COM |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | DAVIS |
| AGENT ATTORNEY FIRST NAME | BRANDON |
| AGENT ATTORNEY MIDDLE NAME | ERIC |
| AGENT ATTORNEY ADDRESS1 | 365 CANAL ST. |
| AGENT ATTORNEY ADDRESS2 | STE. 2000 |
| AGENT ATTORNEY CITY | NEW ORLEANS |
| AGENT ATTORNEY STATE | LA |
| AGENT ATTORNEY POSTAL CODE | 70130 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | ORLEANS PARISH |
| AGENT ATTORNEY PHONE | 15045849312 |
| AGENT ATTORNEY EMAIL ADDRESS | laura.buck@phelps.com |
| LAWFIRM NAME BUSINESS NAME | PHELPS DUNBAR LLP |
| STATE OF HIGHEST COURT | LA |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 2 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 515 MAIN ST. |
| LCA CASE WORKLOC1 CITY | OLEAN |
| WORKSITE COUNTY | CATTARAUGUS |
| LCA CASE WORKLOC1 STATE | NY |
| WORKSITE POSTAL CODE | 14760 |
| LCA CASE WAGE RATE FROM | 320000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 252262 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | DAVIS |
| PREPARER FIRST NAME | BRANDON |
| PREPARER BUSINESS NAME | PHELPS DUNBAR LLP |
| PREPARER EMAIL | laura.buck@phelps.com |
