| LCA CASE NUMBER | I-200-21349-767447 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-12-15 |
| DECISION DATE | 2021-12-22 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | STAFF PHYSICIAN (EMERGENCY MEDICINE) |
| SOC CODE | 29-1063.00 |
| SOC TITLE | Internists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2022-01-02 |
| END DATE | 2025-01-01 |
| 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 | TRINITY HEALTH OF NEW ENGLAND PROVIDER NETWORK ORGANIZATION, INC. |
| TRADE NAME DBA | TRINITY HEALTH OF NEW ENGLAND MEDICAL GROUP |
| EMPLOYER ADDRESS1 | 114 WOODLAND STREET |
| EMPLOYER CITY | HARTFORD |
| EMPLOYER STATE | CT |
| EMPLOYER POSTAL CODE | 06105 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18607144000 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | MURPHY |
| EMPLOYER POC FIRST NAME | HEIDI |
| EMPLOYER POC JOB TITLE | REGIONAL PRACTICE AND PROVIDER TRANSITION MANAGER |
| EMPLOYER POC ADDRESS1 | 1000 ASYLUM AVENUE |
| EMPLOYER POC ADDRESS2 | 4TH FLOOR |
| EMPLOYER POC CITY | HARTFORD |
| EMPLOYER POC STATE | CT |
| EMPLOYER POC POSTAL CODE | 06105 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18607141354 |
| EMPLOYER POC EMAIL | Heidi.Murphy@TrinityHealthOfNE.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | WIZNER |
| AGENT ATTORNEY FIRST NAME | ANDREW |
| AGENT ATTORNEY MIDDLE NAME | LEWIS |
| AGENT ATTORNEY ADDRESS1 | 999 ASYLUM AVENUE |
| AGENT ATTORNEY ADDRESS2 | SUITE 202 |
| AGENT ATTORNEY CITY | HARTFORD |
| AGENT ATTORNEY STATE | CT |
| AGENT ATTORNEY POSTAL CODE | 06105 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 18602498100 |
| AGENT ATTORNEY EMAIL ADDRESS | AWIZNER@LKWVISA.COM |
|
| LAWFIRM NAME BUSINESS NAME | LEETE, KOSTO & WIZNER, LLP |
| STATE OF HIGHEST COURT | CT |
| NAME OF HIGHEST STATE COURT | SUPREME |
| WORKSITE WORKERS | 2 |
| SECONDARY ENTITY | True |
| SECONDARY ENTITY BUSINESS NAME | SAINT MARY'S HOSPITAL, INC. |
| WORKSITE ADDRESS1 | 56 FRANKLIN STREET |
| LCA CASE WORKLOC1 CITY | WATERBURY |
| WORKSITE COUNTY | WATERBURY CITY |
| LCA CASE WORKLOC1 STATE | CT |
| WORKSITE POSTAL CODE | 06706 |
| LCA CASE WAGE RATE FROM | 300000 |
| LCA CASE WAGE RATE TO | 306800 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 176280 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| 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 | HAYFORD |
| PREPARER FIRST NAME | MELISSA |
| PREPARER MIDDLE INITIAL | A |
| PREPARER BUSINESS NAME | LEETE, KOSTO & WIZNER, LLP |
| PREPARER EMAIL | MHAYFORD@LKWVISA.COM |
