| LCA CASE NUMBER | I-200-20365-984952 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-12-30 |
| DECISION DATE | 2021-01-07 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Pediatric Physician |
| SOC CODE | 29-1065.00 |
| SOC TITLE | Pediatricians, General |
| FULL TIME POSITION | False |
| LCA CASE EMPLOYMENT START DATE | 2021-05-01 |
| END DATE | 2024-04-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Upstate Emergency Medicine, Inc. |
| EMPLOYER ADDRESS1 | 750 East Adams Street |
| EMPLOYER CITY | Syracuse |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 13210 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13154644363 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Hermann |
| EMPLOYER POC FIRST NAME | Deborah |
| EMPLOYER POC MIDDLE NAME | T. |
| EMPLOYER POC JOB TITLE | Director of Operations |
| EMPLOYER POC ADDRESS 1 | 750 East Adams Street |
| EMPLOYER POC CITY | Syracuse |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 13210 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 13154644864 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Venter |
| AGENT ATTORNEY FIRST NAME | Brendan |
| AGENT ATTORNEY MIDDLE NAME | J |
| AGENT ATTORNEY ADDRESS1 | 677 Broadway |
| AGENT ATTORNEY ADDRESS2 | Suite 1101 |
| AGENT ATTORNEY CITY | Albany |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 12207 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 15187012773 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Harris Beach PLLC |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 4900 Broad Road |
| WORKSITE ADDRESS2 | Upstate Community Hospital |
| LCA CASE WORKLOC1 CITY | Syracuse |
| WORKSITE COUNTY | ONONDAGA |
| LCA CASE WORKLOC1 STATE | NY |
| WORKSITE POSTAL CODE | 13215 |
| LCA CASE WAGE RATE FROM | 115 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 62.85 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Hofstetter |
| PREPARER FIRST NAME | Joshua |
| PREPARER MIDDLE INITIAL | D |
| PREPARER BUSINESS NAME | Harris Beach PLLC |
| PREPARER EMAIL | [email protected] |
