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Case Number
I-200-19015-621105
1. Indicate the type of visa classification supported by this application (Write classification symbol):
H-1B
1. Job Title
Manager, Nurse
2. SOC (ONET/OES) code
11-9111
3. SOC (ONET/OES) occupation title
Medical and Health Services Managers
4. Is this a full-time position?
Yes
Period of Intended Employment
5. Begin Date (mm/dd/yyyy)
1/23/2019 12:00:00 AM
6. End Date (mm/dd/yyyy)
1/22/2022 12:00:00 AM
7. Worker positions needed/basis for the visa classification supported by this application
Total Worker Positions Being Requested for Certification
1
1. Legal business name
Northwell Health
2. Trade name/Doing Business As (DBA), if applicable
3. Address 1
2000 Marcus Avenue
10. Telephone number
516-321-6604
12. Federal Employer Identification Number (FEIN from IRS)
13. NAICS code (must be at least 4-digits)
622110
Important Note: The information contained in this Section must be that of an employee of the employer who is authorized to act on behalf of
the employer in labor certification matters. The information in this Section must be different from the agent or attorney information listed in
Section E, unless the attorney is an employee of the employer.
1. Contact's last (family) name
Krebs
2. First (given) name
Jodi
4. Contact's job title
Director, Hr Compliance And Immigration
5. Address 1
1111 Marcus Avenue, Entrance 5 - Suite M21
12. Telephone number
516-472-6066
14. E-Mail address
Jkrebs@northwell.edu
1. Is the employer represented by an attorney or agent in the filing of this application? If "Yes", complete the remainder of Section E below.
2. Attorney or Agent's last (family) name
Fisher
3. First (given) name
Theda
5. Address 1
430 Park Avenue 10th Floor
12. Telephone number
2128489886
14. E-Mail address
Theda.fisher@withersworldwide.com
15. Law firm/Business name
Withers Bergman Llp
16. Law firm/Business FEIN
17. State Bar number (only if attorney)
4645776
18. State of highest court where attorney is in good standing (only if attorney)
New York
19. Name of the highest court where attorney is in good standing (only if attorney)
Court Of Appeals
1. Wage Rate (Required)
From: $
115,000.08
To: $
115,000.08
2. Per: (Choose only one)
Year
1. Address 1
270-05 76th AVENUE
5. State/District/Territory
NY
7. Agency which issued prevailing wage
7a. Prevailing wage tracking number (if applicable)
8. Wage level
I
9. Prevailing wage
$ 93,101.00
10. Per: (Choose only one)
11. Prevailing wage source (Choose only one)
11a. Year source published
2019
11b. If "OES", and SWA/NPC did not issue prevailing wage OR "Other" in question 11, specify source
1. Is the employer H-1B dependent?
No
2. Is the employer a willful violator?No
3. If "Yes" is marked in questions I.1 and/or I.2, you must answer "Yes" or "No" regarding whether the
employer will use this application ONLY to support H-1B petitions or extensions of status for exempt H-1B
nonimmigrants?
If you marked "Yes" to questions I.1 and/or I.2 and "No" to question I.3, you MUST read Section I - Subsection 2 of the Labor
Condition Application - General Instructions Form ETA 9035CP under the heading "Additional Employer Labor Condition
Statements" and indicate your agreement to all three (3) additional statements summarized below.
- Displacement: Non-displacement of the U.S. workers in the employer's workforce
- Secondary Displacement: Non-displacement of U.S. workers in another employer's workforce; and
- Recruitment and Hiring: Recruitment of U.S. workers and hiring of U.S. workers applicant(s) who are equally or better qualified than the H-1B nonimmigrant(s).
4. I have read and agree to Additional Employer Labor Condition Statements A, B, and C above and as fully explained in Section I - Subsections 1 and 2 of the Labor Condition Application - General Instructions Form ETA 9035CP.
- Yes
- No
1. Last (family) name of hiring or designated official
Krebs
2. First (given) name of hiring or designated official
Jodi
4. Hiring or designated official title
Director, Hr Compliance And Immigration
1. Last (family) name
Hameed
2. First (given) name
Sarah
4. Firm/Business name
Withers Bergman Llp
5. E-Mail address
Sarah.hameed@withersworldwide.com
By virtue of the signature below, the Department of Labor hereby acknowledges the following:
This certification is valid
From 1/23/2019 12:00:00 AM
To 1/22/2022 12:00:00 AM
Department of Labor, Office of Foreign Labor Certification
Determination Date (date signed)
1/15/2019 12:00:00 AM
Case Number
I-200-19015-621105
The Department of Labor is not the guarantor of the accuracy, truthfulness, or adequacy of a certified LCA.
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