| LCA CASE NUMBER | I-200-20129-555169 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-05-08 |
| DECISION DATE | 2020-05-15 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician - Critical Care Medicine and Pulmonary Medicine |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-07-01 |
| END DATE | 2023-06-30 |
| 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 | Hackensack University Medical Group, P.C. |
| TRADE NAME DBA | a/k/a North Jersey Primary Care Associates |
| EMPLOYER ADDRESS1 | 30 Prospect Street |
| EMPLOYER CITY | Hackensack |
| EMPLOYER STATE | NJ |
| EMPLOYER POSTAL CODE | 7601 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15519962000 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Simmons |
| EMPLOYER POC FIRST NAME | Deborah |
| EMPLOYER POC JOB TITLE | Director, Talent Selection |
| EMPLOYER POC ADDRESS1 | 343 Thornall Street |
| EMPLOYER POC CITY | Edison |
| EMPLOYER POC STATE | NJ |
| EMPLOYER POC POSTAL CODE | 7737 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18488884499 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Fox |
| AGENT ATTORNEY FIRST NAME | Rosanna |
| AGENT ATTORNEY MIDDLE NAME | M |
| AGENT ATTORNEY ADDRESS1 | 61 S. Paramus Road |
| AGENT ATTORNEY ADDRESS2 | Suite 422 |
| AGENT ATTORNEY CITY | Paramus |
| AGENT ATTORNEY STATE | NJ |
| AGENT ATTORNEY POSTAL CODE | 7652 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 19088731801.0 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Lepore Taylor Fox LLP |
|
| STATE OF HIGHEST COURT | NJ |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Y |
| SECONDARY ENTITY BUSINESS NAME | Hackensack University Medical Center |
| WORKSITE ADDRESS1 | 30 Prospect Street |
| LCA CASE WORKLOC1 CITY | Hackensack |
| WORKSITE COUNTY | BERGEN |
| LCA CASE WORKLOC1 STATE | NJ |
| WORKSITE POSTAL CODE | 7601 |
| LCA CASE WAGE RATE FROM | 314500.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 230672.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Fox / #31 |
| PREPARER FIRST NAME | Rosanna |
| PREPARER MIDDLE INITIAL | M |
| PREPARER BUSINESS NAME | Lepore Taylor Fox LLP |
| PREPARER EMAIL | [email protected] |
